> ## Content Index > Fetch the complete content index at: https://www.missionviewpoint.com/llms.txt > Use this file to discover other available public pages before exploring further. # The Battle for ABA's Tech Stack - URL: https://www.missionviewpoint.com/the-battle-for-abas-tech-stack/ - Published: 2026-10-27T17:38:09.000Z - Updated: 2026-10-27T17:39:24.000Z - Author: Scott Dickson - Tags: ABA Stack, ABA Software, Category: Practice Management, Platform: CentralReach, Platform: Hi Rasmus, Platform: Brellium, Platform: Lumary **Large providers are finally willing to consider switching systems. Capital is betting on more than that.** ***Part Two of MissionViewpoint's series: Where Capital Is Betting on ABA*** A significant part of the investment thesis behind newer ABA practice management platforms in 2024 and 2025 was that **large providers would become willing to replace the market's dominant incumbent**. Newer platforms promised more modern architectures, better data access, and relief from limitations providers had been working around for years. But enterprise replacement has been **slower to materialize** than some anticipated. Supporting the industry's largest providers requires operational depth that few alternative platforms have demonstrated. Depending on how you define "proven," there may still be fewer than a handful with **meaningful operational exposure** at top-20 provider scale. In conversations across the market, I'm now seeing something **different**. Large providers are **increasingly willing** to seriously evaluate replacing their established practice management systems, rather than **simply expressing frustration** with them. Better integration, faster innovation, and easier access to their own data are **becoming more important** to them. The inertia hasn't disappeared, but the willingness to consider change is catching up with the alternatives being developed. That makes the timing of this fall's investments interesting. In September, Hi Rasmus announced a [$50 million minority investment](https://www.missionviewpoint.com/hi-rasmus-raises-50-million-what-kind-of-platform-is-it-becoming/) from Updata Partners. In October, Brellium [announced another $23 million](https://www.missionviewpoint.com/brelliums-23-million-bet-beyond-aba-without-leaving-it-behind/) to expand its AI-powered clinical compliance business. Neither investment is premised on **replacing the practice management system** at the center of a large provider's operation. Yet both suggest investors see substantial opportunities in the technology surrounding it. Read alongside Motivity's [acquisition of Calmanac](https://www.missionviewpoint.com/motivitys-calmanac-acquisition-is-about-more-than-practice-management/) in May, which added significant operational capabilities to a clinical platform, these developments suggest the enterprise market is opening in **more than one direction**. ## Why the Center Has Held The incumbent position in enterprise ABA has never rested entirely on software capability. CentralReach is the clearest illustration. Roper Technologies [acquired](https://www.missionviewpoint.com/centralreach-joins-roper-a-milestone-for-them-and-a-pivotal-moment-for-the-aba-market/) the company in 2025 in a transaction well over $1 billion, and despite significant [management changes](https://www.missionviewpoint.com/the-head-chef-leaves-the-kitchen/) since, the business appears to be performing well financially. That's not the profile of a struggling incumbent. The deeper protection is **operational**. For a large provider, scheduling, authorizations, clinical documentation, billing, and reporting all run through its practice management system thousands of times a day, and replacing it is **a major operational project**. I explored those economics in a three-part series earlier this year, and the conclusion still holds: [dissatisfaction rarely becomes switching](https://www.missionviewpoint.com/almost-everyone-wants-to-switch-almost-no-one-does/). An incumbent system doesn't need to be the best one available. It only needs to remain preferable to the disruption of replacing it. That calculation has two sides: the **value** of something better and the **cost** of getting there. Both are changing. ## The Cost of Staying Put Has Changed In May, I argued that utilization scrutiny was [blurring the line ](https://www.missionviewpoint.com/the-road-from-medicaid-pressure-leads-directly-to-prior-authorization/)between clinical and back-office infrastructure, and that platforms would increasingly be judged on whether they could connect clinical, operational, and financial context. The Wall Street Journal's October investigation made that problem more visible. The Journal built a [utilization benchmark](https://www.missionviewpoint.com/aba-never-built-a-common-utilization-benchmark-the-wall-street-journal-did/) from Medicaid claims, comparing weekly treatment hours across providers and following children who switched between organizations. Its analysis measures billed services **rather than clinical appropriateness**, but it demonstrated how much can be inferred from administrative data alone. Payors already possess comparable claims information for their own members. The providers' principal defense was that their patients had greater clinical needs. That may be true. But the evidence needed to substantiate those differences—assessments, treatment goals, and progress toward them—often resides in systems that **don't connect cleanly** to authorized, delivered, and billed hours. A provider may be able to explain one child's treatment intensity by reviewing the clinical record. Explaining the same patterns across ten thousand children is a **different capability**. That **changes the economics** of existing technology environments. The cost of staying put **isn't limited** to subscription fees and inefficient workflows. It increasingly includes the operational and clinical questions the organization **cannot readily answer** when a payor produces its own comparison. Better infrastructure becomes more valuable under those conditions, but that doesn't automatically make replacing the practice management system the answer. ## Three Bets on the Same Spend Consider a provider operating fifty clinics across three states. A Medicaid plan has flagged its weekly treatment hours per patient as substantially above the network average and asked the organization to **explain the difference**. Its clinicians believe the explanation exists. Its systems **cannot produce it consistently** across the population. That provider has three potential paths, each corresponding to a different opportunity for technology companies and their investors. The first is to **replace its practice management system** with a platform that brings clinical and operational capabilities together. Motivity's acquisition of Calmanac illustrates this approach. [Motivity](https://www.missionviewpoint.com/platform-card-motivity-2/) began with clinical data collection and has been expanding into broader operational functionality. Calmanac brought scheduling, credentialing, authorization management, and other capabilities, along with experience supporting operations at a top-10 ABA provider. That combination addresses one of the principal objections to replacing an established system. Migration strategies are also becoming **more practical**. Some providers can limit the historical data they convert, retain legacy systems for audit and collections, and transition active operations at defined points in the authorization cycle. That doesn't eliminate the risk of changing systems, but it can considerably **reduce the scope of the transition**. The second path is to **retain the practice management system while moving the clinical layer to a specialist**. This is where the [Hi Rasmus](https://www.missionviewpoint.com/platform-card-hi-rasmus-2/) investment becomes particularly interesting. The company has emphasized clinical technology and an ecosystem approach rather than positioning itself solely as a comprehensive practice management competitor. We don't know precisely how its $50 million will be deployed. But Hi Rasmus illustrates an **alternative to consolidating every capability** within one platform: the clinical layer may become valuable enough to operate independently across multiple practice management systems. Motivity's acquisition points toward bringing clinical and operational capabilities together. Hi Rasmus illustrates the possibility of keeping them separate, with integration allowing each platform to specialize. The third path is to **retain the core system and add specialized capabilities alongside it**. [Brellium](https://www.missionviewpoint.com/platform-card-brellium-2/)'s AI-powered documentation review and compliance technology is an example. It can deliver value across existing clinical and practice management systems without requiring the provider to replace them. These three paths **aren't mutually exclusive**. A provider might add documentation review this year, adopt a different clinical platform next year, and eventually replace its PM system. But they represent different views of where enterprise technology value will reside, and **capital is now supporting all three**. ## Where the Leverage Moves The opportunity to separate clinical and operational platforms introduces another question. The Journal's utilization analysis demonstrated the **importance of connecting clinical need to delivered services**. If a provider's assessments and goal progress live in one platform's system while authorizations, scheduling, and billing live in another's, explaining treatment intensity **becomes an integration and data problem**. That has consequences for the practice management system that remains. A PM system whose clinical functions move to a specialist may retain scheduling, authorizations, billing, and other essential operations, but it **no longer holds** all the clinical context needed to explain those transactions. Over time, that could shift its role toward **being a system of record** for operational transactions rather than the ***primary environment*** through which the organization understands and manages care delivery. And it could happen without the provider replacing its PM system. **The reverse is also possible**. An incumbent could strengthen its position by connecting specialized clinical and operational capabilities, preserving its role as the system through which the organization manages and interprets its operations. This suggests another source of **competitive leverage**: the ability to reliably connect clinical, operational, and financial information across systems. That doesn't mean the integration layer itself becomes the most valuable technology. Integrations can become standardized, and platforms can develop or acquire those capabilities themselves. The greater opportunity belongs to whichever technology environment allows a provider to turn distributed information into **consistent operational decisions** and **defensible clinical evidence**. In that sense, enterprise competition isn't only about which platform owns the most functionality. It's also about which platform, or combination of platforms, allows the organization to make the **best use** of its information. ## What Would Show the Market Is Opening? There's a meaningful difference between enterprise providers expressing dissatisfaction, seriously evaluating alternatives, and completing migrations. The first has been common for years. The second is becoming more prevalent. The third would provide the **strongest evidence** that the economics of enterprise platform replacement have materially changed. But completed migrations aren't the only meaningful signal. Specialized platforms **expanding** within incumbent accounts, clinical systems adopted **independently** of practice management, and providers investing in **data infrastructure** outside their core systems would all indicate that enterprise technology spending is becoming **more accessible** to competitors. Incumbents can remain financially healthy through any of these developments. An established vendor doesn't need to lose most of its customers for competitors to build substantial businesses in a market that was previously difficult to penetrate. The replacement opportunity that attracted investors to newer platforms is becoming more tangible. But a broader realignment is already underway. **One group** of technology companies is assembling more complete platforms. **Another** is demonstrating that valuable clinical capabilities can operate independently. **A third** is building specialized services that work alongside whatever systems providers already use. These approaches can coexist within the same enterprise, but they also **compete** for technology spending, operational responsibility, and control over the information providers depend on. > **The enterprise ABA technology market is opening not simply because established practice management systems are becoming easier to replace, but because more of the work those systems once controlled can be performed elsewhere.** For investors, the opportunity is no longer limited to winning the next enterprise PM replacement. It's also about identifying which capabilities providers will pay to add, move, or connect—and which companies can capture that spending without assuming the operational risks of delivering care themselves. Click [here](https://www.missionviewpoint.com/#/portal/signup) to subscribe for more insights on ABA technology, operations, and strategy. --- Next in Where Capital Is Betting on ABA: **Part Three — Where Capital Goes Next**. > *As enterprise technology competition intensifies, which capabilities become strategic enough to build, partner for, or acquire? And how much of the capital flowing into ABA technology companies will ultimately remain focused on ABA?*